Universität zu Köln

Hokamp, Nils Grosse, Hellerbach, Alexandra, Gierich, Andreas, Jordan, David W., Visser-Vandewalle, Veerle, Maintz, David and Haneder, Stefan (2018). Reduction of Artifacts Caused by Deep Brain Stimulating Electrodes in Cranial Computed Tomography Imaging by Means of Virtual Monoenergetic Images, Metal Artifact Reduction Algorithms, and Their Combination. Invest. Radiol., 53 (7). S. 424 - 432. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-0210

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Abstract

Objectives: The aim of this study was to evaluate the reduction of artifacts from deep brain stimulation electrodes (DBS) using an iterative metal artifact reduction algorithm (O-MAR), virtual monoenergetic images (VMI), and both in combination in postoperative spectral detector computed tomography using a dual-layer detector (spectral detector computed tomography [SDCT]) of the head. Material and Methods: Nonanthropomorphic phantoms with different DBS leads were examined on SDCT; in 1 phantom periprocedural bleeding was simulated. A total of 20 patients who underwent SDCT after DBS implantation between October 2016 and April 2017 were included in this institutional review board-approved retrospective study. Images were reconstructed using standard-of-care iterative reconstruction (CI) and VMI, each with and without O-MAR processing (IR and MAR). Artifacts were quantified by determining the percentage integrity uniformity in an annular region of 1.4 cm(2) around the DBS lead; a percentage integrity uniformity of 100% indicates the absence of artifacts. In phantoms, conspicuity of blood was determined on a binary scale, whereas in patients, image quality, DBS lead assessment, and extent of artifact reduction were assessed on Likert scales by 2 radiologists. Statistical significance was assessed using analysis of variance and Wilcoxon tests; sensitivity and specificity were calculated. Results: The O-MAR processing significantly decreased artifacts in phantom and patients (P <= 0.05), whereas VMI did not reduce artifact burden compared with corresponding CI (P > 0.05): for example, CI-IR/MAR and 200 keV-IR/MAR for patients: 76.3%/90.7% and 75.9%/91.2%, respectively. Qualitatively, overall image quality was not improved (P > 0.05) and MAR improved DBS assessment (CI-IR/MAR: 2 [1-3]/3 [2-4]; P <= 0.05) and reduced artifacts significantly (P <= 0.05). The O-MAR processing increased sensitivity for bleeding by 160%. In some cases, new artifacts were induced through O-MAR processing, none of which impaired diagnostic image assessment. Discussion: The investigated O-MAR algorithm reduces artifacts from DBS electrodes and should be used in the assessment of postoperative patients; however, combination with VMI does not provide an additional benefit.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hokamp, Nils Grosse UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellerbach, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Gierich, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Jordan, David W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Haneder, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-182213
DOI:	10.1097/RLI.0000000000000460
Journal or Publication Title:	Invest. Radiol.
Volume:	53
Number:	7
Page Range:	S. 424 - 432
Date:	2018
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-0210
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DUAL-ENERGY CT; ORTHOPEDIC HARDWARE; PARKINSONS-DISEASE; LAYER CT; RECONSTRUCTIONS; IMPLANTS; EXTRAPOLATION; ACCURACY; SOFTWARE; MRI Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18221